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Background: Breast cancer which has a high mortality rate is now known to decrease due to early detection with the advent of digital mammography screening. During mammography, compression of the breast is highly variable. However, various factors that affect the amount of compression force applied have not been studied thoroughly. Hence, the aim of our study is to enumerate the factors affecting the variability in the applied compression force during mammography. Methods: Data related to breast compression force applied, breast composition, size, and compressed breast thickness along with the details about the technologists who performed the study on each patient were collected from 323 patients who underwent mammography. Intertechnologist variability in compression force application was evaluated using Fisher’s exact test and associations between other factors with respect to breast compression force were established using analysis of variance and linear regression models. Results: A positive correlation between the compression force and the age, breast composition, compressed breast thickness, and breast size was obtained. Technologists’ years of experience were also positively related to the applied compression force. Conclusions: This study provides evidence of the fact that compression application should be varied as per the requirement with respect to the patient’s breast structure, only then can we acquire images with high quality and high diagnostic value, thus reducing recall rates. It also shows that the compression force applied in this study was much lower than those applied in other countries like the UK, US, Netherlands, Norway, etc., which could mean that there is a need to increase the force applied.

Broad access to efficacious immunizations is important for mitigating the COVID-19 pandemie. Healthcare personnel, particularly paramedical workers, may be more susceptible to infection during the covid pandemic due to a variety of causes. The purpose of this research is to assess paramedical staff members' opinions on the COVID-19 vaccine.

Background WHO reported that the epidemic SARS-CoV-2 spread was a public health emergency of international tension in January 2020 and pandemic in March 2020. In this regard, National Institute of Mental Health and Neuro Sciences (NIMHANS) launched a national helpline with the support of the Ministry of Health and Family Welfare for addressing psychosocial issues and mental health concerns of people during the COVID-19 pandemic. The recorded calls made to the National Psychosocial Support helpline were analysed to elicit the psychosocial issues seen among the elderly during the pandemic. Methods The data of 70 randomly selected helpline callers were collected by using the sociodemographic data sheet and the semistructured questionnaire. The study employed descriptive research design. Results In total, 71.1% of callers belonged to the 60-70 years’ age group. 57.1% of callers had approached the helpline by themselves. 38.6% of the callers had reported a preexisting mental illness, of which the majority (33%) reported anxiety and/or sleeplessness. 28.6% of callers complained of comorbid medical issues. Interventions provided to the callers were in the form of supportive psychotherapy (84.28%), the COVID-19-related information (72.85%), referral services (62.9%), lifestyle modifications (41.42%), and behavioural activation (35.71%). Conclusion Study findings indicate that the older population encountered several mental health issues during COVID-19, and the telephonic interventions were the most feasible, accessible, and helpful method to reach out to them.

Abstract Drug resistance poses a significant obstacle to the success of anti-cancer therapy in head and neck cancers (HNCs). We aim to develop a platform for visualizing and analyzing molecular expression alterations associated with HNC drug resistance. Through data mining, we convened differentially expressed molecules and context-specific signaling events involved in drug resistance. The driver genes, interaction networks and transcriptional regulations were explored using bioinformatics approaches. A total of 2364 differentially expressed molecules were identified in 78 distinct drug-resistant cells against 14 anti-cancer drugs, comprising 1131 mRNAs, 746 proteins, 62 lncRNAs, 257 miRNAs, 1 circRNA, and 166 post-translational modifications. Among these, 255 molecules were considerably, the signature driver genes of HNC drug resistance. Further, we also developed a landscape of signaling pathways and their cross-talk with diverse signaling modules involved in drug resistance. Additionally, a publicly-accessible database named “HNCDrugResDb” was designed with browse, query, and pathway explorer options to fetch and enrich molecular alterations and signaling pathways altered in drug resistance. HNCDrugResDb is also enabled with a Drug Resistance Analysis tool as an initial platform to infer the likelihood of resistance based on the expression pattern of driver genes. HNCDrugResDb is anticipated to have substantial implications for future advancements in drug discovery and optimization of personalized medicine approaches.

Introduction: Any significant changes in the growth and development of any aspect of life will ultimately affect the health-related quality of life (HRQOL) of children with nephrotic syndrome. Various factors can influence treatment adherence, which can promote or decline the child’s quality of life (QOL). Objective: To assess the quality of life and adherence to treatment regimen and to identify the predictors of QOL and adherence to treatment regimen among children with nephrotic syndrome. Method: A cross-sectional study was conducted among 59 children with nephrotic syndrome who attended the Paediatric Department of AIIMS, Bhubaneswar, using the PedsQL 4.0 generic core scale to assess the quality of life and adherence response scale. Both descriptive and inferential statistics were performed using the SPSS 20 version. Results: The overall QOL median score was 93.48, with an IQR of 18.48, which indicated good QOL. A median score of treatment adherence was 16 with IQR 5, which indicated that the overall treatment adherence was good. Type of nephrotic syndrome (P = 0.014), developmental stage (P = 0.018), education of mother (P = 0.026), and occupation of mother (P = 0.026) were the variables predicted QOL. Duration of disease (P = 0.006) and duration of therapy (P = 0.005) significantly predicted treatment adherence. Conclusion: Children need continuous reinforcement on treatment adherence strategies to attain and maintain good QOL so that it can help to reduce the disease severity. Controlling the predictors that influence the QOL and treatment adherence has to be counseled among the parents so that their adherence can be sustained throughout the disease process to maintain good QOL.

To compare the alveolar ridge augmentation using either a 1:1 combination of autograft and bovine graft or bovine graft alone and a slow resorbing collagen membrane with simultaneous placement of implants.

Abstract The integration of natural fibers into Fiber Reinforced Polymers (FRPs) has emerged as a promising avenue for sustainable and high-performance composite materials. Natural fibers, derived from plants, offer notable advantages such as renewability, low cost, and environmental friendliness. Among these natural fibers, Hibiscus Rosa-Sinensis (HRS) plant fibers have gained significant attention owing to their widespread availability and unique mechanical properties. In this study, HRS fibers were chemically treated using Sodium Hydroxide (NaOH), Potassium Permanganate (KMnO4), and Acetic Acid (CH3COOH) at different weight percentages (3, 4, 5 Wt.%) and solutionizing times (1, 2, 3 h) based on Taguchi’s L27 orthogonal array. The fibers, extracted from epidermis of the stems, underwent cleaning and chemical treatment after water retting. The crystallinity index, determined via X-ray Diffraction (XRD), indicated a maximum value of 65.77%. Thermo-gravimetric analysis (TGA) exhibited a degradation temperature of 365.24 °C and a material loss of 63.11%. Potassium Permanganate treatment at 4 Wt.% and 3 h of solutionizing time has yielded the best results. Multi-Layer Perceptron Artificial Neural Network (MLP-ANN) has been successfully applied to accurately predict the output physical characteristics of chemically treated HRS fibers using experimental data. The results are in close alignment with the literature. Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray Spectroscopy (EDS) analyses have provided valuable insights into the microstructure and constituents of the chemically treated HRS fibers. This research emphasises on the effectiveness of the chemical treatment process in enhancing the properties of HRS plant fibers for potential composite applications.

Aims: Diabetes mellitus (DM) is associated with dry mouth, reduced saliva, taste changes, and periodontal disease. This study aimed to evaluate and determine the correlation between oral health status and glycaemic control levels in patients with type 2 DM (T2DM). Methods: This cross-sectional study was conducted on patients with T2DM aged 35-65 years. Glycemic control levels were categorized as good control (≤7% of HbA1c) and poor control (>7% of HbA1c). Full mouth plaque score (FMPS), full mouth bleeding score (FMBS), probing depth (PD), and clinical attachment level (CAL) were determined, along with xerostomia (using a standard questionnaire) and hyposalivation (using modified Schirmer test, MST). Results: This study included 70 individuals with T2DM, comprising 49 males (70%) and 21 females (30%) with a mean age of 55.36±8.3 and 49.36±6.8 years, respectively. Among those with poor glycemic control, a significantly higher prevalence of xerostomia (52.2%), hyposalivation (47.8%), and periodontitis (moderate; 47.8% and severe; 21.7%) was observed compared with those with good control (p=0.027, 0.001, 0.007, respectively). HbA1c exhibited a significant moderate positive correlation with FMPS (r=0.447; p=0.001) and a low correlation with FMBS (r=0.283; p=0.018) and CAL (r=0.301; p=0.011). Conclusions: The study concluded that individuals with poor glycemic control for T2DM have a higher incidence of xerostomia, hyposalivation, and compromised periodontal health, resulting in a decline in their oral health status.

Abstract Background Online education has emerged as a crucial tool for imparting knowledge and skills to students in the twenty-first century, especially in developing nations like India, which previously relied heavily on traditional teaching methods. Methods This study delved into the perceptions and challenges experienced by students and teachers in the context of online education during the COVID-19 pandemic. Data were collected from a sample of 491 dental students and 132 teachers utilizing a cross-sectional research design and an online-validated survey questionnaire. Results The study’s findings revealed significant insights. Internet accessibility emerged as a major impediment for students, with online instruction proving more effective for theoretical subjects compared to practical ones. Although most teachers expressed comfort with online teaching, they highlighted the absence of classroom interaction as a significant challenge. Conclusion This study comprehensively examines the perspectives of both students and teachers regarding online education during the pandemic. The results carry substantial implications for the academic community, underscoring the need to address internet access issues and explore ways to enhance engagement and interaction in online learning environments.

BackgroundArtificial intelligence (AI) models are being increasingly studied for the detection of variations and pathologies in different imaging modalities. Nasal septal deviation (NSD) is an important anatomical structure with clinical implications. However, AI-based radiographic detection of NSD has not yet been studied. ObjectiveThis research aimed to develop and evaluate a real-time model that can detect probable NSD using cone beam computed tomography (CBCT) images. MethodsCoronal section images were obtained from 204 full-volume CBCT scans. The scans were classified as normal and deviated by 2 maxillofacial radiologists. The images were then used to train and test the AI model. Mask region-based convolutional neural networks (Mask R-CNNs) comprising 3 different backbones—ResNet50, ResNet101, and MobileNet—were used to detect deviated nasal septum in 204 CBCT images. To further improve the detection, an image preprocessing technique (contrast enhancement [CEH]) was added. ResultsThe best-performing model—CEH-ResNet101—achieved a mean average precision of 0.911, with an area under the curve of 0.921. ConclusionsThe performance of the model shows that the model is capable of detecting nasal septal deviation. Future research in this field should focus on additional preprocessing of images and detection of NSD based on multiple planes using 3D images.

Background: Over the years, Indian regulations have undergone numerous amendments, including stringent reporting deadlines, relatedness requirements, and compensation obligations for serious adverse event (SAE). A historic change, new drugs and trial rules-2019, was proposed on March 19, 2019. The purpose of the study was to ascertain whether various stakeholders were reporting in accordance with the evolving SAE criteria. Materials and Methods: Data were retrieved after the Ethics Committee’s approval between August 2014 and December 2021. Data gathered before March 19, 2019, were categorized as “BEFORE” data, while the remaining data were categorized as “AFTER.” Utilizing causality, on-site SAE reporting, and the ethics committee review procedure, we evaluated the compliance. The data were evaluated using descriptive statistics, and the Chi-square or Mann–Whitney tests were used to compare the “BEFORE” and “AFTER” groups. Results: A total of 77 SAEs were reported in 26 clinical trials, where most clinical trials were phase III. Endocrine projects made up 9/26 (34.61%). In the cardiology studies, the greatest SAE distribution was 21 SAEs/89 participants (23.59%) with approximately 48% of these being vascular. The “AFTER” group noticed a decrease in the total number and length of SAE subcommittee meetings. In the “AFTER” group, there was a significantly higher median number of agenda items/meetings (8 [4.5–10.75]) (P < 0.0001). The median interval between the onset of SAE and the first reporting date, however, was just 1 day (interquartile range: 1–5 days). In nondeath SAEs, there was no significant difference in the compensation paid. In the “AFTER” group, there were no discrepancies in reporting SAE. Conclusion: There is acceptable adherence to SAE reporting criteria.

Abstract Metabolic dysfunction-associated steatotic liver disease (MASLD) is an important public health problem owing to its high prevalence and associated morbidity and mortality secondary to progressive liver disease and cardiovascular events. Resmetirom, a selective thyroid hormone receptor-β agonist has been developed as a therapeutic modality for MASLD. This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of resmetirom compared to a placebo in the treatment of MASLD. Eligible studies were systematically identified by screening PubMed, Scopus, Web of Science, Cochrane library, Embase, and ClinicalTrials.gov from 2014 to 2024. Only randomized controlled trials comparing the efficacy and safety of resmetirom in the treatment of MASLD against placebo were included in the analysis. Meta-analysis was performed using RevMan 5.4 software. Four studies with low risk of bias and involving a total of 2359 participants were identified. The metanalysis included only three clinical trials with 2234 participants. A significant reduction in MRI-proton density fat fraction (MRI-PDFF) with 80 mg Resmetirom compared to that with placebo [SMD − 27.74 (95% CI − 32.05 to − 32.42), p

Abstract In today’s context, there is a clear preference for DC microgrids over AC microgrids due to their better compatibility with generating sources, loads, and battery energy storage systems (BESS). However, the intermittent nature of renewable resources disrupts the balance between power generation and load demand. It raises concerns regarding power management and quality in the power system. Control strategies are essential to address these challenges. This article focuses on developing a novel control strategy to ensure stability in microgrid systems. The proposed control structure utilizes a second-order multi-agent system (MAS) to enhance the power-sharing and coordination in the microgrid network. For effective control of battery energy storage units, a Voltage–Power (V-P) reference-based droop control and leader–follower consensus method is employed. The control approach consists of primary and secondary control layers. The primary layer uses a V-P reference-based droop control strategy to allocate load components to storage units. The secondary control layer aims to restore DC bus voltage using a MAS-based consensus protocol. The MAS approach offers greater flexibility and requires less computational power than other strategies such as Model Predictive Control (MPC). The enhanced control structure incorporates a current ratio modification loop to adjust the current ratio between the converters, thereby modifying gain and improving the voltage profile. This novel control optimizes the reliability and stability of the proposed DC microgrid system. The effectiveness of the enhanced consensus-based secondary control strategy is demonstrated using the MATLAB/Simulink platform.

Introduction: Chronic Ankle Instability (CAI) is an injury that presents persistent instability and “giving way” symptoms. The higher rate of reinjury following an initial Lateral Ankle Sprain (LAS) is associated with the development of CAI, which affects athletic and functional performance. Impairment of musculotendinous receptors following an initial ankle sprain may result in recurrent ankle instability. Some studies have suggested an association between CAI and issues with static and dynamic balance. Comparisons of static balance between recreational badminton and volleyball players and dynamic balance between recreational badminton and volleyball players with CAI are required to provide athletes with the proper balance training exercises. Aim: To analyse the static balance of badminton and volleyball recreational players with CAI using the Balance Error Scoring System (BESS) and a Plantar Pressure Analysis System (PPAS), as well as the dynamic balance of those players using the Y Balance Test (YBT). Materials and Methods: A cross-sectional study was conducted where recreational players with CAI who play badminton and volleyball were screened using the Cumberland Ankle Instability Tool (CAIT), and 46 participants were selected based on inclusion and exclusion criteria. The study was conducted in the indoor and outdoor stadiums of NITTE (Deemed to be University), Mangaluru, Karnataka, India. The study duration was from March 2023 to March 2024. Ethical clearance was obtained from the same university for the study. Following this, static and dynamic balance of each group was assessed using BESS (number of errors), PPAS (sway velocity), and YBT (distance reached by the limb). The static balance between the groups and dynamic balance between the groups were analysed in Jamovi software using independent sample t-test. Results: Following the analysis, static balance between badminton and volleyball recreational players using BESS showed a non significant difference with a p-value of 0.282, while PPAS showed non significant differences with p-values of 0.174 for double leg stance and 0.063 for single leg stance. Similarly, dynamic balance between badminton and volleyball recreational players using YBT showed non significant differences with p-values of 0.467, 0.768, and 0.299 for anterior, posteromedial, and posterolateral directions, respectively. Conclusion: The study concluded that there was no significant difference in static as well as dynamic balance between badminton and volleyball recreational players with CAI. However, it is important to evaluate the static and dynamic balance of recreational players to enhance performance and prevent injuries.

Introduction: Resin composites have been commonly used in restorative dentistry over the years. The longevity of restorations depends upon various physical properties like as solubility. Composite solubility can lead to deleterious effects on the polymer structure. Aim: To evaluate and compare the solubility of a single shade resin composite in comparison to a conventional resin composite in artificial saliva. Materials and Methods: In the present in-vitro study, 44 pellets (10 mm × 1 mm) were prepared from each material. The pellets were divided into two groups (n=22) based on the immersion period of two days and seven days. They were incubated, weighed using an analytical balance, and then immersed in artificial saliva. Weighing was done again after the completion of the immersion period, and solubility was calculated. Paired and independent sample t-tests were used to compare the solubility of both materials after two days and seven days. Results: The differences of solubility values for the single shade composite and conventional composite at two and seven-day intervals were (p=0.031) and (p=0.019), respectively, which were statistically significant. On inter-group comparison, the difference in solubility of the single shade composite at two days was significantly lower compared to conventional composites (p=0.024). Whereas, no significant difference was observed in solubility values between both groups at seven days (p=0.102). Conclusion: The performance of the single shade composite in terms of solubility was better in comparison with conventional composite.

Abstract Background Medical universities often face the ongoing challenge of identifying and supporting at-risk students to enhance retention rates and academic success. This study explores a comprehensive analysis of perceived at-risk factors impeding academic and career aspirations and compares the perspectives of students and faculty in a medical school. Methods We focused on first and second-year medical (MBBS) students and teaching faculty in an international medical college offering a twinning program in India and Malaysia. Our investigation involved a comprehensive assessment of 25 at-risk factors through Likert-type questionnaires distributed to 250 MBBS students and 50 teaching faculty. Results Our findings revealed distinct disparities in perceptions between faculty and students regarding mean scores of classroom engagement (p = 0.017), procrastination (p = 0.001), unrealistic goals (p = 0.026), emotional/behavioral problems (p = 0.008), limited key social skills (p = 0.023), and a non-supportive home environment (p = 0.001). These differences underscore the need for increased communication and understanding between faculty and students to address these risk factors effectively. In contrast, no significant disparities were observed among faculty and students’ perceptions concerning mean scores of various potential at-risk factors, including academic unpreparedness, cultural/language barriers, individual guidance/mentoring, limited communication skills, racism/sexism, self-confidence, self-respect, self-concept, motivation, underprepared for current academic challenges, self-discipline, negative social network, negative peer culture, transportation time, college financial cost, college evaluation culture bias, broken college relationships, teaching methodology, and learning disabilities. However, varying degrees of influence were perceived by faculty and students, suggesting the importance of individualized support. Conclusion This study contributes to the academic community by shedding light on the multifaceted nature of at-risk factors influencing student success. It underscores the need for proactive measures and tailored interventions to enhance student retention in higher education and academic achievement, fostering a sustainable foundation for lifelong learning and growth.

Abstract Background Scientific evidence highlights the influence of biological sex on the relationship between stress and metabolic dysfunctions. However, there is limited understanding of how diet and stress concurrently contribute to metabolic dysregulation in both males and females. Our study aimed to investigate the combined effects of high-fat diet (HFD) induced obesity and repeated stress on fear-related behaviors, metabolic, immune, and hypothalamic outcomes in male and female mice. Methods To investigate this, we used a highly reliable rodent behavioral model that faithfully recapitulates key aspects of post-traumatic stress disorder (PTSD)-like fear. We subjected mice to footshock stressor followed by a weekly singular footshock stressor or no stressor for 14 weeks while on either an HFD or chow diet. At weeks 10 and 14 we conducted glucose tolerance and insulin sensitivity measurements. Additionally, we placed the mice in metabolic chambers to perform indirect calorimetric measurements. Finally, we collected brain and peripheral tissues for cellular analysis. Results We observed that HFD-induced obesity disrupted fear memory extinction, increased glucose intolerance, and affected energy expenditure specifically in male mice. Conversely, female mice on HFD exhibited reduced respiratory exchange ratio (RER), and a significant defect in glucose tolerance only when subjected to repeated stress. Furthermore, the combination of repeated stress and HFD led to sex-specific alterations in proinflammatory markers and hematopoietic stem cells across various peripheral metabolic tissues. Single-nuclei RNA sequencing (snRNAseq) analysis of the ventromedial hypothalamus (VMH) revealed microglial activation in female mice on HFD, while male mice on HFD exhibited astrocytic activation under repeated stress. Conclusions Overall, our findings provide insights into complex interplay between repeated stress, high-fat diet regimen, and their cumulative effects on health, including their potential contribution to the development of PTSD-like stress and metabolic dysfunctions, emphasizing the need for further research to fully understand these interconnected pathways and their implications for health.

The new advancement in percutaneous intervention procedures, which provides more accurate needle placement compared to other modalities, is Augmented Reality (AR). It provides the operator with 3-dimensional (3D) or 2-dimensional (2D) structures of the anatomy along with the target during surgery to get a precise needle placement into the target. The review highlights that using AR systems for needle navigation and placement can become productivity in various interventional procedures. The AR navigation system reduces radiation exposure, procedural time, risk to the patient, and ensures higher accuracy of needle placement than conventional Computed Tomography (CT)-guided percutaneous procedure systems. The AR system can provide precisely guided needle insertion and reduce the risk of complications. As technology and research are increasing, new techniques, such as automatic image-hologram registration, can be brought into the picture. This review compares conventional image-guided procedure systems with the AR system in the interventional radiology field. This review also provides detailed information about AR as a promising tool for optimising needle placement in interventional procedures, paving the way for safer and more effective clinical practices.

Vitamin D has multifaceted roles in brain function beyond its traditional role in bone health, impacting neurotransmitters, inflammation, and mood-regulating brain areas where its receptors are present. Conversely, Vitamin D deficiency is often observed in obese individuals. Metreleptin, a synthetic form of human leptin, has demonstrated efficacy in promoting weight loss and alleviating depression among obese patients. However, there is limited direct evidence linking metreleptin to depression reduction or establishing an interaction between metreleptin and Vitamin D in this context. Vitamin D’s neurotrophic and immunomodulatory properties influence neurotransmitter regulation, including serotonin, dopamine, and norepinephrine, vital for mood stability. The presence of Vitamin D Receptors (VDR) in regions of the brain linked to depression further supports its role in mood regulation. Moreover, Vitamin D’s anti-inflammatory effects contribute to mitigating brain inflammation associated with depression. Given the inverse relationship between obesity and Vitamin D levels, obese individuals are at higher risk of Vitamin D deficiency. Metreleptin, as a synthetic leptin analogue, has demonstrated significant efficacy in reducing obesity. Thus, the plausible combination of Vitamin D and metreleptin presents a potential novel strategy for managing depression in obese individuals. Though these therapies may address the intricate interplay of depression in the context of obesity, rigorous research is essential to validate their efficacy and safety in tandem.

Background: Pregnant women with severe acute respiratory syndrome coronavirus-2 disease 2019 [COVID-19] appear to be at greater risk of morbidity and mortality complications in pregnancy. Objective: This prospective analysis aimed to assess maternal and neonatal outcomes among hospitalized pregnant women with COVID-19. Methods: The present prospective study included COVID-19-positive pregnant women referred to our tertiary care centre. Data related to demographics, clinical characteristics, diagnosis, laboratory parameters, histopathological findings, procedure, treatment regimen and clinical outcomes were recorded. and analysed. We studied maternal and neonatal outcomes among hospitalised pregnant women with COVID-19. Results: During the period from April 2020 to April 2022, we studied 83 women clinically diagnosed with COVID-19. Placenta previa (n = 3), decrease in foetal movement (n = 2) and premature rupture of membranes (n = 1) were observed among pregnant women with COVID-19. A total of 31 women had pre-term delivery (37–40 weeks gestation). Of these 83 patients, 17.6% had pneumonia, 14.7% had hypothyroidism, 8.8% had gestational diabetes mellitus and 5.9% had gestational hypertension. Elevated baseline C-reactive protein (21.6 mg/dL) and interleukin-6 (16.6 pg/mL) levels were observed. Mother-to-child COVID-19 transmission was observed in one neonate. The length of hospital stay had ranged from 2 to 77 days in COVID-19 positive mothers. Eighty two patients (98.8%) were managed conservatively and were successfully discharged. Conclusions: Our observations suggest that pregnant women with COVID-19 have a significant impact on maternal health and pregnancy outcomes.

Abstract Whilst. pharmacological therapies remain the cornerstone of pain management in chronic pain, factors including the current opioid epidemic have led to non-pharmacological techniques becoming a more attractive proposition. We explored the prevalence of medical device use and their treatment efficacy in non-cancer pain management. A systematic methodology was developed, peer reviewed and published in PROSPERO (CRD42021235384). Key words of medical device, pain management devices, chronic pain, lower back pain, back pain, leg pain and chronic pelvic pain using Science direct, PubMed, Web of Science, PROSPERO, MEDLINE, EMBASE, PorQuest and ClinicalTrials.gov. All clinical trials, epidemiology and mixed methods studies that reported the use of medical devices for non-cancer chronic pain management published between the 1st of January 1990 and the 30th of April 2022 were included. 13 studies were included in systematic review, of these 6 were used in the meta-analysis. Our meta-analysis for pain reduction showed that transcutaneous electrical nerve stimulation combined with instrument-assisted soft tissue mobilization treatment and pulsed electromagnetic therapy produced significant treatment on chronic lower back pain patients. Pooled evidence revealed the use of medical device related interventions resulted in 0.7 degree of pain reduction under a 0–10 scale. Significant improvement in disability scores, with a 7.44 degree reduction in disability level compared to a placebo using a 50 score range was also seen. Our analysis has shown that the optimal use of medical devices in a sustainable manner requires further research, needing larger cohort studies, greater gender parity, in a more diverse range of geographical locations.

Objectives: Diabetic foot syndrome is becoming increasingly common in India with a prevalence ranging from 24.9% to 49%. Diabetic foot syndrome patients have an increased likelihood of developing ulcers in their feet. Accordingly, this study evaluates the influence of photobiomodulation on altered plantar pressure distribution and ankle biomechanics in individuals with diabetic foot syndrome. Methods: A total of 20 diabetic foot syndrome patients with an absence of 10 g monofilament in one out of six sites at the plantar surface of feet, a biothesiometer for vibration perception threshold of >20 V, and diminished or absent ankle reflexes were included. The evaluation of ankle biomechanics was performed by SIMI motion analysis. In addition, the plantar pressure distribution was measured by the WinTrack pressure platform at baseline and the end of 10 sessions. They were treated with scanning mode on the foot plantar surface and probe laser at the popliteal fossa region for three sessions per week, for ten sessions. Results: Plantar pressure parameters were significantly improved (P

Systemic lupus erythematosus (SLE) is an autoimmune disorder with protean manifestations. most commonly affecting women Cardiovascular manifestations are common but rare at initial presentation. Our patient presented with impending cardiac tamponade and was subsequently diagnosed with SLE. A 31-year-old female presented with fever, rash, and progressive exertional dyspnea. On examination, she had an elevated JVP and muffled heart sounds and features of pulmonary hypertension her baseline blood investigations showed acute kidney injury, albuminuria, and grossly elevated BNP. Chest radiography showed an enlarged cardiac silhouette and echocardiography showed large pericardial effusion with impending cardiac tamponade for which the patient underwent emergency pericardiocentesis. ANA profile confirmed our diagnosis of SLE with positive anti-dsDNA, anti-nucleosomes, anti-histones, anti-SSA, and anti-Jo 1. Being positive she was treated with pulse steroids and hydroxychloroquine. Renal biopsy was also done which showed class IV lupus nephritis. She improved clinically and was discharged with oral steroids, mycophenolate mofetil, and hydroxychloroquine. Cardiac tamponade is a life-threatening condition and SLE is an important differential to be considered during evaluation.

In dental implant insertion, an artificial foundation is prepared for the prosthetic device, which involves the surgical positioning of the implant in the jaw bone. The success of dental implants relies on the osseointegration process. The biomechanical factors, such as stress and strain, developed during the insertion affect the jawbone and its surroundings. In this current study, the stresses during the implant insertion in the mandibular jawbone bone are analyzed using three-dimensional explicit dynamic analysis, and the Cowper–Symonds model is implemented with the damage model. The implant’s design has a substantial impact on stress distribution within the cancellous bone during the insertion procedure. The stress variation takes place as the implant moves into the pre-drilled hole. This is because of the contact between the bone and the fixture on the implant. The upper edge of the predrilled site shows that the stresses are more at the crestal region of the implant due to surface area. There is a gradual increase in the stress level as the implant reaches the lower edge from the top edge. This is because of the concept of mechanical interlocking. Clinicians can use this information to anticipate and address potential stress-related challenges during implant placement.

Restorative dentistry is the repairing of damaged teeth and restoring oral health and function. Dental implants are typically placed within the cortical bone of the jaw to provide stability and support for prosthetic restorations. The successful restoration of complex anatomical features of the maxillary anterior is difficult for prosthodontists. Using a 3D slicer, CT scan images were used to create a detailed three-dimensional model of the maxilla bone. This study utilizes ANSYS Workbench, a finite element software program, to analyze the abutment angles, ranging from 0° to 25°, and the impact stress distribution within peri-implant bone. The outcomes of our studies align with and substantiate certain evidence in the literature documenting bone resorption, specifically at the level of the implant neck and near the cortical bone. The study aims to provide a comprehensive understanding of angled abutment stress patterns in the bone surrounding dental implants, offering valuable insights for clinical applications in critical areas of the mouth.

Artificial intelligence (AI) is a discipline within the field of computer science that encompasses the development and utilization of machines capable of emulating human behavior, particularly regarding the astute examination and interpretation of data. AI operates through the utilization of specialized algorithms, and it includes techniques such as deep (DL), and machine learning (ML), and natural language processing (NLP). As a result, AI has found its application in the study of pharmaceutical chemistry and healthcare. The AI models employed encompass a spectrum of methodologies, including unsupervised clustering techniques applied to drugs or patients to discern potential drug compounds or appropriate patient cohorts. Additionally, supervised ML methodologies are utilized to enhance the efficacy of therapeutic drug monitoring. Further, AI-aided prediction of the clinical outcomes of clinical trials can improve efficiency by prioritizing therapeutic intervention that are likely to succeed, hence benefiting the patient. AI may also help create personalized treatments by locating potential intervention targets and assessing their efficacy. Hence, this review provides insights into recent advances in the application of AI and different tools used in the field of pharmaceutical medicine.

Summary: Background: While many patients seem to recover from SARS-CoV-2 infections, many patients report experiencing SARS-CoV-2 symptoms for weeks or months after their acute COVID-19 ends, even developing new symptoms weeks after infection. These long-term effects are called post-acute sequelae of SARS-CoV-2 (PASC) or, more commonly, Long COVID. The overall prevalence of Long COVID is currently unknown, and tools are needed to help identify patients at risk for developing long COVID. Methods: A working group of the Rapid Acceleration of Diagnostics-radical (RADx-rad) program, comprised of individuals from various NIH institutes and centers, in collaboration with REsearching COVID to Enhance Recovery (RECOVER) developed and organized the Long COVID Computational Challenge (L3C), a community challenge aimed at incentivizing the broader scientific community to develop interpretable and accurate methods for identifying patients at risk of developing Long COVID. From August 2022 to December 2022, participants developed Long COVID risk prediction algorithms using the National COVID Cohort Collaborative (N3C) data enclave, a harmonized data repository from over 75 healthcare institutions from across the United States (U.S.). Findings: Over the course of the challenge, 74 teams designed and built 35 Long COVID prediction models using the N3C data enclave. The top 10 teams all scored above a 0.80 Area Under the Receiver Operator Curve (AUROC) with the highest scoring model achieving a mean AUROC of 0.895. Included in the top submission was a visualization dashboard that built timelines for each patient, updating the risk of a patient developing Long COVID in response to clinical events. Interpretation: As a result of L3C, federal reviewers identified multiple machine learning models that can be used to identify patients at risk for developing Long COVID. Many of the teams used approaches in their submissions which can be applied to future clinical prediction questions. Funding: Research reported in this RADx® Rad publication was supported by the National Institutes of Health. Timothy Bergquist, Johanna Loomba, and Emily Pfaff were supported by Axle Subcontract: NCATS-STSS-P00438.

Objectives The objectives of this study were to evaluate the accuracy of morphometry of skull base and palate in gender discrimination using cone beam computed tomography (CBCT) scanning and to assess the accuracy of the results among a sample of the Arab population Materials & Methods Using CBCT scans, a cross-sectional analysis was conducted on 142 consented patients who underwent various dental procedures at the University Dental Hospital, Sharjah (UDHS). Of these patients, 70 were females and 72 were males, with respective means of 38.5 and 36.2 years. Eleven parameters related to skull base and palatal region were measured on the CBCT scans by two expert radiologists followed by statistical analysis. Results There was significant gender-based difference in the mean palatal width (PW) (p = 0.001), mean palatal height (PH) (p = 0.005). Among other skull base region parameters that were significant in term of gender-based difference like; the clivus length (CL) (p

Background The paucity of state-supported rehabilitation for chronically ill patients with long-term tracheostomies has ramifications of prolonged hospital-stay, increased burden on acute-care resources, and nosocomial infections. Few interventions describe home rehabilitation of adult tracheostomized patients. Almost none involve stakeholders. This paper describes the All-India Institute of Medical Sciences (AIIMS) ICU rehabilitation (AIR) healthcare intervention developed to facilitate home rehabilitation of chronically ill tracheostomized patients. Methods The AIR intervention development was based on the experience-based codesign theory (EBCD). A core research-committee studied prevalent knowledge and gaps in the area. Patients-carer and health-care stakeholders’ experiences of barriers and facilitators to home care resulted in an intervention with interlinked components: family-carer training, equipment bank, m-health application, and follow-up, guided by the Medical Research Council (MRC) framework. Healthcare stakeholders (doctors, nurses, medical equipment vendors) and patient-carer dyads were engaged to gather experiences at various stages to form smaller codesign teams for each component. Multiple codesign meetings iteratively allowed refinement of the intervention over one year. The Template for Intervention Description and Replication (TIDieR) checklist was used to report the AIR intervention. Results The first component comprised a minimum of three bedside hands-on training sessions for carers relating to tracheostomy suction, catheter care, monitoring oxygenation, enteral feeding, skincare, and physiotherapy, buttressed by pictorial-books and videos embedded in a mobile-application. The second was an equipment-bank involving a rental-retrieval model. The third component was a novel m-health tool for two-way communication with the core group and community of other patient-carers in the project for follow-up and troubleshooting. Home visits on days 7 and 21 post-discharge assessed patient hygiene, nutrition, physiotherapy, and established contact with the nearest primary healthcare facility for the future. Conclusions Findings support the EBCD-based development using active feedback from stakeholders. Assessment of feasibility, process and effectiveness evaluation will follow.

Endosalpingiosis is characterized by the presence of the ectopic tubal epithelium and is known to occur in pelvic organs, peritoneum, urinary bladder, and retroperitoneal nodes. Occurrence in pelvic lymph nodes must be differentiated from metastasis. We present a case of 30-year-old female who underwent staging laparotomy for suspected bilateral ovarian cancer. Histopathology revealed bilateral borderline serous tumor with two pelvic nodes having benign glandular structures of fallopian tubal morphology. WTI was positive in ovarian tumor and nodal structures but with pattern difference. The Ki-67 labeling index was 2% in nodal lesions as compared to 9% in ovarian tumor, confirming endosalpingiosis. Nodal endosalpingiosis must not be misdiagnosed as “metastasis” to avoid overtreatment in ovarian neoplasms. It is pertinent to recognize this entity rightly as it has a definitive role in clinical decision and treatment protocols. Glandular structures in lymph nodes must undergo a thorough workup, especially when associated with neoplastic lesions elsewhere.

Omental infarction (OI) is an uncommon cause of acute abdominal pain. A high index of clinical suspicion is required for diagnosis of OI as the incidence is less than 1 %, presenting with abdominal pain. We report primary OI’s clinical and radiological profile from a single tertiary care hospital in India.

BACKGROUND: Diabetes is a significant cause of blindness, kidney failure, heart attacks, stroke, and lower limb amputation. Diabetes is a growing challenge in India, with an estimated 8.7% diabetic population (between 20 and 70 years). The macrovascular disease is the primary pathogenic mechanism underlying coronary heart disease (CHD). Microvascular disease may play a prominent role in CHD development in diabetic individuals. Diabetic retinopathy (DR) is a specific marker of microvascular disease in type 2 diabetes. It is unclear, however, if the presence of DR signifies an increased risk of CHD. OBJECTIVES: 1. To assess the proportion of DR and 10-year risk of developing CHD among study subjects 2. To assess the relationship between DR and CHD risk. MATERIAL AND METHODS: A cross-sectional study was conducted between January 2021 and November 2023 at a tertiary hospital in Tumkur among patients with type 2 diabetes mellitus. Data were collected using a pretested semi-structured questionnaire, and subjects were examined for DR and 10-year risk of developing CHD and data were analyzed. RESULTS: Among the study subjects, 65% were male, 74.3% were on oral hypoglycemic drugs, and 12.9% had a family history of CHD. DR was seen in 49.3% of study subjects. 10% of study subjects hada ≥ 40% risk of developing CHD. There was a statistically significant association between DR and the risk of CHD (P < 0.01). CONCLUSION: DR may be associated with increased cardiovascular disease risk. A careful cardiovascular assessment and follow-up may be required in individuals with DR.

Abstract Molecular responses to alcohol consumption are dynamic, context-dependent, and arise from a complex interplay of biological and external factors. While many have studied genetic risk associated with drinking patterns, comprehensive studies identifying dynamic responses to pharmacologic and psychological/placebo effects underlying binge drinking are lacking. We investigated transcriptome-wide response to binge, medium, and placebo alcohol consumption by 17 healthy heavy social drinkers enrolled in a controlled, in-house, longitudinal study of up to 12 days. Using RNA-seq, we identified 251 and 13 differentially expressed genes (DEGs) in response to binge drinking and placebo, respectively. Eleven protein-coding DEGs had very large effect sizes in response to binge drinking (Cohen’s d > 1). Furthermore, binge dose significantly impacted the Cytokine-cytokine receptor interaction pathway (KEGG: hsa04060) across all experimental sequences. Placebo also impacted hsa04060, but only when administered following regular alcohol drinking sessions. Similarly, medium-dose and placebo commonly impacted KEGG pathways of Systemic lupus erythematosus, Neutrophil extracellular trap formation, and Alcoholism based on the sequence of drinking sessions. These findings together indicate the “dose-extending effects” of placebo at a molecular level. Furthermore, besides supporting alcohol dose-specific molecular changes, results suggest that the placebo effects may induce molecular responses within the same pathways regulated by alcohol.

Synostosis is an immobile joint created by the ossification of two bones. About 0.3% of ribs have synostosis, an unexpected radiographic finding. The present study aims to detail every instance of rib synostosis and provide an overview of its evolutionary, morphological, and clinical significance for anatomists, radiologists, and surgeons. Four hundred dry specimens of adult ribs of anonymous sex and origin in the Yenepoya Medical College, Department of Anatomy's osteological collections, were subject to the current investigation. In addition to one forked and bridged rib and two occurrences of costovertebral synostosis, we discovered five examples of manubriocostal synostosis. All synostotic bones underwent morphological analysis, and measurements were taken using vernier calipers. There is limited research on rib abnormalities in clinical medicine. Clinicians and radiologists must be conversant with how these variances look on imaging. These anomalies highlight the early organogenesis changes that may be associated with stillbirths, cancer, and other defects.

Background and Aim: Stroke is a leading cause of permanent disability in developing nations. Motor impairment in stroke contributes to limitations in activities of daily life, participation in community, and overall quality of life. Recovery following stroke is challenged by poor lower-limb muscle performance interfering with balance, gait, and functional tasks. Objective: The objective of this study was to investigate the effect of Russian current over the quadriceps muscle in 10-m walk performance and Brunnstrom stages of lower-extremity recovery in chronic stroke survivors. Materials and Methods: The Institutional Review Board approval was obtained for this pilot study, and a total of 36 chronic stroke survivors were recruited from the outpatient department of Alva's College of Physiotherapy and Research Center, Moodubidire, Karnataka. Consent was obtained from the voluntary participants, and they were randomly assigned to one of the two groups; intervention and the control groups. Participants in the intervention group received Russian current over the quadriceps muscle in addition to the conventional rehabilitation, whereas the control group participants received only conventional rehabilitation. The study duration was 6 weeks. The outcomes measured were 10-m walk test and Brunnstrom stages of lower-extremity recovery. Results: Statistical analysis was performed with SPSS statistical software. The Kolmogorov–Smirnov test was performed for normality. The paired t-test, within-group analysis, demonstrated a significant increase in the 10-m walk test (P < 002) and Brunnstrom stage of lower extremity (P < 0.043) for the intervention group. The independent t-test demonstrated a highly significant (P = 0.001) value for the intervention group than the control group. Conclusion: Statistical results conclude that Russian current is effective in improving 10-m walk performance and Brunnstrom stages of motor recovery of lower limb in chronic stroke survivors.

Background and Aim: Non-Typhoidal Salmonellae (NTS) is emerging as a major health problem globally. They cause foodborne infections, especially gastroenteritis as well as extraintestinal manifestations. As this is a zoonotic disease, certain animal sources such as poultry, egg, meat and dairy products are implicated. Fruits and vegetables too contaminated by manure of infected animal excreta are possible vehicles of transmission of this disease. The present report analyzes the spectrum of NTS with seroprofiling, isolated in our institute for the last 12 years. Materials and Methods: Fresh fecal samples from patients with acute gastroenteritis and blood samples from cases of bacteremia were processed according to the standard protocol. Nonlactose fermenting colonies resembling Salmonella were subjected to biochemical characterization and antimicrobial susceptibility testing followed by serotyping. Results: One hundred fifty-two NTS strains were isolated from feces and 13 from blood. Serotyping of these strains revealed that the most common NTS species was Salmonella Typhimurium (44.8%), followed by Salmonella Oslo (15.2%) and Salmonella Weltevreden (11.5%). Many rare strains were also encountered in our study. Conclusion: As many of the NTS species are biochemically similar, serotyping of NTS should be made mandatory to know the burden of the disease and to detect the emergence of new serovars. Emergence of multidrug resistance in NTS strains is a major concern nowadays. It is very essential to adopt strict quality measures in poultry, fish, dairy, and meat processing units as they are widely distributed in animals. In addition, strategies should be formulated by health education and public awareness programs to sensitize the population regarding this menace.

Background and Aim: Lip prints just like fingerprints follow unique patterns in every individual and are said to vary significantly even within the same family. Lip prints can be recognized from 6th week of intrauterine life and remain unchanged throughout their life. The objective of the present study was to evaluate personal identification through lip print patterns with additional reference to twins and members of the same family. Materials and Methods: Lips of 75 males, 75 females, and 30 twins were studied in various quadrants. In addition, the pattern in the middle 10 mm of the lower lip was also evaluated to note the pattern distribution and dominance of the type of pattern in different genders. Lip print patterns in five families across three generations (eight members each of the same family) were observed for the existence of inheritance of patterns from their ancestors. Results: Among males and females, the most common pattern in the middle 10 mm of the lower lip is Type III (34.66%) and Type IV (32%), respectively. In the middle 10 mm of the lower lip, 33.33% of twins have similar lip patterns but with differences in its arrangements. The result showed different lip print patterns even in twins and among the members of the same family across three generations, with some similar patterns which suggesting hereditary influences in lip prints. Conclusion: In the present, we can see that lip prints are unique and permanent for every human being even among twins and individuals of the same family.

Study Design Basic research. Purpose This finite element (FE) analysis (FEA) aimed to compare the biomechanical parameters in multilevel posterior cervical fixation with the C7 vertebra instrumented by two techniques: lateral mass screw (LMS) vs. transpedicular screw (TPS). Overview of Literature Very few studies have compared the biomechanics of different multilevel posterior cervical fixation constructs. Methods Four FE models of multilevel posterior cervical fixation were created and tested by FEA in various permutations and combinations. Generic differences in fixation were determined, and the following parameters were assessed: (1) maximum moment at failure, (2) maximum angulation at failure, (3) maximum stress at failure, (4) point of failure, (5) intervertebral disc stress, and (6) influence of adding a C2 pars screw to the multilevel construct. Results The maximum moment at failure was higher in the LMS fixation group than in the TPS group. The maximum angulation in flexion allowed by LMS was higher than that by TPS. The maximum strain at failure was higher in the LMS group than in the TPS group. The maximum stress endured before failure was higher in the TPS group than in the LMS group. Intervertebral stress levels at C6–C7 and C7–T1 intervertebral discs were higher in the LMS group than in the TPS group. For both models where C2 fixation was performed, lower von Mises stress was recorded at the C2–C3 intervertebral disc level. Conclusions Ending a multilevel posterior cervical fixation construct with TPS fixation rather than LMS fixation at the C7 vertebra provides a stiff and more constrained construct system, with higher stress endurance to compressive force. The constraint and durability of the construct can be further enhanced by adding a C2 pars screw in the fixation system.

Study Design A retrospective cohort study. Purpose To determine outcomes following all-posterior surgery using computed tomography navigation, hybrid stabilization, and multiple anchor point techniques in patients with neurofibromatosis type 1 (NF-1) and dystrophic scoliosis. Overview of Literature Previous studies favored antero-posterior fusion as the most reliable method; however, approaching the spine anteriorly was fraught with significant complications. With the advent of computer assisted navigation and multiple anchor point method, posterior only approach is reporting successful outcomes. Methods This study included patients who underwent all-posterior surgical deformity correction for dystrophic NF-1 curves. Coronal and sagittal Cobbs angles, apical rotation, and the presence of dystrophic features were evaluated before surgery. Postoperatively, sagittal, coronal, and axial correction, implant position, and implant densities were evaluated. The decline in curve correction and implant-related complications were evaluated at follow-up. Clinical outcomes were evaluated using the Scoliosis Research Society-22 revised index. Results This study involved 50 patients with a mean age of 13.6 years and a mean follow-up duration of 5.52 years. With a mean coronal flexibility of 18.7%, the mean apical vertebral rotation (AVR), preoperative coronal Cobb angle, and sagittal kyphosis were 27.4°, 64.01°, and 47.70°, respectively. The postoperative mean coronal Cobb angle was 30.17° (p

Study Design A retrospective cohort study. Purpose This study aimed to understand the role of magnetic resonance imaging (MRI) in predicting neurological deficits in traumatic lower lumbar fractures (LLFs; L3–L5). Overview of Literature Despite studies on the radiological risk factors for neurological deficits in thoracolumbar fractures, very few have focused on LLFs. Moreover, the potential utility of MRI in LLFs has not been evaluated. Methods In total, 108 patients who underwent surgery for traumatic LLFs between January 2010 and January 2020 were reviewed to obtain their demographic details, injury level, and neurology status at the time of presentation (American Spinal Injury Association [ASIA] grade). Preoperative computed tomography scans were used to measure parameters such as anterior vertebral body height, posterior vertebral body height, loss of vertebral body height, local kyphosis, retropulsion of fracture fragment, interpedicular distance, canal compromise, sagittal transverse ratio, and presence of vertical lamina fracture. MRI was used to measure the canal encroachment ratio (CER), cross-sectional area of the thecal sac (CSAT), and presence of an epidural hematoma. Results Of the 108 patients, 9 (8.3%) had ASIA A, 4 (3.7%) had ASIA B, 17 (15.7%) had ASIA C, 21 (19.4%) had ASIA D, and 57 (52.9%) had ASIA E neurology upon admission. The Thoracolumbar Injury Classification and Severity score (p=0.000), CER (p=0.050), and CSAT (p=0.019) were found to be independently associated with neurological deficits on the multivariate analysis. The receiver operating characteristic curves showed that only CER (area under the curve [AUC], 0.926; 95% confidence interval [CI], 0.860–0.968) and CSAT (AUC, 0.963; 95% CI, 0.908–0.990) had good discriminatory ability, with the optimal cutoff of 50% and 65.3 mm2, respectively. Conclusions Based on the results, the optimal cutoff values of CER >50% and CSAT >65.3 mm2 can predict the incidence of neurological deficits in LLFs.

Abstract Background Yttrium-stabilized zirconia (YSZ) and alumina are the most commonly used dental esthetic crown materials. This study aimed to provide detailed information on the comparison between yttrium-stabilized zirconia (YSZ) and alumina, the two materials most often used for esthetic crowns in dentistry. Methodology The ground-state energy of the materials was calculated using the Cambridge Serial Total Energy Package (CASTEP) code, which employs a first-principles method based on density functional theory (DFT). The electronic exchange–correlation energy was evaluated using the generalized gradient approximation (GGA) within the Perdew (Burke) Ernzerhof scheme. Results Optimization of the geometries and investigation of the optical properties, dynamic stability, band structures, refractive indices, and mechanical properties of these materials contribute to a holistic understanding of these materials. Geometric optimization of YSZ provides important insights into its dynamic stability based on observations of its crystal structure and polyhedral geometry, which show stable configurations. Alumina exhibits a distinctive charge, kinetic, and potential (CKP) geometry, which contributes to its interesting structural framework and molecular-level stability. The optical properties of alumina were evaluated using pseudo-atomic computations, demonstrating its responsiveness to external stimuli. The refractive indices, reflectance, and dielectric functions indicate that the transmission of light by alumina depends on numerous factors that are essential for the optical performance of alumina as a material for esthetic crowns. The band structures of both the materials were explored, and the band gap of alumina was determined to be 5.853 eV. In addition, the band structure describes electronic transitions that influence the conductivity and optical properties of a material. The stability of alumina can be deduced from its bandgap, an essential property that determines its use as a dental material. Refractive indices are vital optical properties of esthetic crown materials. Therefore, the ability to understand their refractive-index graphs explains their transparency and color distortion through how the material responds to light..The regulated absorption characteristics exhibited by YSZ render it a highly attractive option for the development of esthetic crowns, as it guarantees minimal color distortion. Conclusion The acceptability of materials for esthetic crowns is strongly determined by mechanical properties such as elastic stiffness constants, Young's modulus, and shear modulus. YSZ is a highly durable material for dental applications, owing to its superior mechanical strength.

Abstract Background Digital storytelling is an arts-informed approach that engages short, first-person videos, typically three to five minutes in length, to communicate a personal narrative. Prior to the pandemic, digital storytelling initiatives in health services research were often conducted during face-to-face workshops scheduled over multiple days. However, throughout the COVID-19 lockdowns where social distancing requirements needed to be maintained, many digital storytelling projects were adapted to online platforms. Methods As part of a research project aiming to explore the day surgery treatment and recovery experiences of women with breast cancer in Peel region, we decided to pivot our digital storytelling process to an online format. During the process, we observed that the online digital storytelling format had multiple opportunities and challenges to implementation. Results This paper outlines our promising practices and lessons learned when designing and implementing an online digital storytelling project including pre-production, production and post-production considerations. Conclusions We provide lessons learned for future teams intending to conduct an online digital storytelling project.

Background: The prevalence of dyspepsia in general practice consultations ranges from 4% to 5%, whereas it accounts for approximately 20–40% of consultations in the field of gastroenterology. Aims and Objectives: This study was carried out with the objective of estimating the percentage of Helicobacter pylori-infected people who havedyspepsia and exploring the relationship between infection and clinical manifestation. Materials and Methods: This was a hospital-based observational study conducted at a tertiary care teaching health-care facility from January 2023 to June 2023. All 50 patients with symptoms of dyspepsia were included in the study with the help of non-probability purposive sampling after their written and informed consent. A pre-designed and pre-tested structured pro forma was used to collect detailed history, clinical findings, and endoscopic findings from patients with dyspepsia. Gastritis and ulceration characteristics were observed by endoscopy, while histopathological examination (HPE) and rapid urease test (RUT) (for confirmation of H. pylori) were performed on endoscopy-obtained biopsy specimens. Results: Mean age of the patients was 46.69±15.78 with 65.4% (n=34) being males. The sample was classified into cases positive for H. pylori (13; 25%) and cases negative for H. pylori (39; 75%), according to the RUT outcome, 21.20% (n=11) had a history of smoking, 25% (n=13) had Type II DM, and 25% of patients presented with upper abdominal bloating and epigastric pain. On endoscopy, the majority of patients revealed grade III (n=22, 42.30%) gastritis and no ulceration (n=29, 55.80%), with the maximum showing a chronic non-specific lesion (n=20, 38.5%) on HPE. Comorbidities (χ2=12.56, P=0.028), endoscopic findings (χ2=10.50, P=0.032), and ulcerations (χ2=20.02, P

Dental caries and periodontal disease are two of the most common oral diseases caused by bacterial infections. Traditional medicine in India has a long history of using plant extracts for dental care. Spilanthes acmella (S. acmella), also known as the “Toothache Plant,” is a medicinal plant that has been traditionally used for its medicinal properties but has not been extensively studied for its applicability and use in dentistry. This study aims to investigate the antimicrobial action of S. acmella ethanol extract on Streptococcus mutans (S. mutans), and Lactobacillus fermentum (L. fermentum), which causes dental caries, and Porphyromonas gingivalis (P. gingivalis), Capnocytophaga gingivalis (C. gingivalis), which causes periodontal infection. The ethanol extract of S. acmella in various dilutions of 10mg/ml, 20mg/ml, 40mg/ml, 80mg/ml, and 100mg/ml was tested for its antibacterial activity against the bacteria as mentioned above using the agar well diffusion method. Erythromycin 0.125mg/ml was used as a positive control, whereas distilled water was used as a negative control. The Minimum inhibitory concentration (MIC) and Minimum bactericidal concentration (MBC) were determined by the broth dilution method. The results of this study have shown that the ethanol extract of S. acmella demonstrated concentration-dependent inhibition of bacterial growth (13-16mm diameter), with the highest concentration of 100mg/ml showing the strongest effect. The findings of this study support the use of the S. acmella plant extract in the treatment of dental caries and periodontal infection and suggest that it may be a viable alternative to traditional antimicrobial agents.

Introduction: In 20-49% of patients with Systemic Lupus Erythematosus (SLE), Lupus Nephritis (LN) is a major complication and, therefore, an important prognostic determinant of SLE. The Activity and Chronicity Indices (AI and CI), used as adjuncts to the histological classification of LN, assist in identifying patients who will benefit from immuno-suppressive therapy. Aim: To investigate the correlation of AI and CI in patients with biopsy-proven LN with clinical and laboratory findings. Materials and Methods: A cross-sectional study was conducted as the Departments of Pathology and Nephrology, JSS Medical College and Hospital Mysore, India from January 2023 to March 2023, by retrieving the data of 56 patients with biopsy proven LN. AI and CI were assessed and classified. Data from multiple groups were compared using Pearson’s chi-square test, and between two groups using independent samples t-test with Statistical Package for Social Sciences (SPSS) version 21.0. Pearson’s correlation coefficient (r-value) was calculated using Microsoft excel 2021. Results: Renal biopsies from 56 cases with biopsy-proven LN were studied, with a mean age of 28±10.30 years and a M:F ratio of 1:10.2. Of the 56 biopsies studied, active lesions were seen in 47 (83.9%) and chronic lesions in 21 (37.5%). AI showed statistical significance with hypertension (p=0.049) and haematuria (p=0.005), with proteinuria (p=0.001, r=0.72), serum creatinine (p=0.037, r=0.62), and blood urea nitrogen (p=0.003, r=0.55) showing a statistically significant positive correlation. CI showed a statistically significant positive correlation with proteinuria (p=0.028, r=0.039) and serum creatinine (p=0.010, r=0.58). Both AI and CI showed statistical significance with the degree of renal insufficiency, with CI (p=0.008) displaying a stronger statistical significance than AI (p=0.012). Conclusion: In conclusion, the management and prognosis of patients with suspected LN are greatly facilitated through information obtained from renal biopsy, especially AI and CI, which are useful guides to treatment. It is important to study renal biopsy for the constellation of features in LN for better patient management.

Introduction: Tobacco smoking is a common addiction in our society. The toxic chemical compounds present in tobacco smoke cause epithelial damage and inflammation of the airways. Chronic smoking results in the thickening of the pulmonary arterial wall and vasoconstriction, leading to the development of pulmonary arterial hypertension. Hence, measurement of pulmonary artery diameter using Contrast Enhanced Computed Tomography (CECT) may be helpful in the early detection of pulmonary arterial hypertension. Aim: To compare the diameters of the Main Pulmonary Artery (MPA), Right Pulmonary Artery (RPA), and Left Pulmonary Artery (LPA) using CECT thorax in smokers and non-smokers. Materials and Methods: A cross-sectional study was conducted from April 2021 to March 2022 in the department of radio-diagnosis, KS Hegde Hospital, Karnataka, India, consisting of 100 patients referred for CECT thorax in the age group of 18-85 years. They were divided into two groups: smokers and non-smokers, with 50 patients in each group. They were further categorised into three age groups: < 50 years, 50-60 years, and >60 years. The widest diameters of the MPA were measured at the level of bifurcation of the artery and perpendicular to the long axis of the artery. At this level, RPA and LPA diameters were measured at the widest portion on 1.25 mm axial images of the arterial phase. Variation in the pulmonary artery diameter was compared between smokers and non-smokers with respect to age and analysed by unpaired t-test and Pearson correlation. Results: Diameters of MPA, RPA, and LPA were statistically significant (p0.05) was shown between age and MPA, RPA, and LPA diameter in non-smokers. The mean MPA diameter showed a significant difference (p

Background Human metapneumovirus (HMPV) is a common respiratory pathogen that causes respiratory tract infections. In India, HMPV has been identified as one of the leading causes of morbidity and mortality in infants and young children with respiratory tract infections. The most reported sublineages of HMPV in India are B1, B2, A2b and A2c.Objective A retrospective study was conducted to determine the circulating genotypes of HMPV among SARI cases from January 2016 to December 2018.Materials and methods Positive throat swab samples were confirmed with real-time RT–PCR. Subsequently, these samples were analysed using semi-nested conventional RT–PCR targeting the G gene, followed by sequencing and phylogenetic analysis. Clinical data analysis was also performed using SPSS 15.0 software.Results All 20 samples from the SARI cases were classified under the A2c sublineage of HMPV. Phylogenetic analysis indicated that these strains were genetically related to those circulating in Japan, China, and Croatia. Among the samples, ten showed 111-nucleotide duplications, while the other ten had 180-nucleotide duplications.Conclusion Clinical analysis showed that four cases had coinfections with other pathogens. Our extensive analysis of patient samples determined that HMPV, especially the A2c genotype, significantly contributed to SARI cases within our study population, which signifies the importance of considering HMPV as a probable aetiological agent when investigating SARI outbreaks.

Background: This study aimed to provide a robust picture of the journey of service users with complex mental health needs by evaluating the perspectives of service users and carers with lived experience of services and gaining clinician views about decision making in relation to this cohort.Methods: A qualitative design was used. Service users (n = 11), carers (n = 10) and clinicians (n = 18) took part in semi-structured interviews, which were transcribed verbatim and analysed using thematic analysis.Results: The following themes were identified by participants: ‘relationships with staff,’ ‘treatment options, pathways and availability,’ ‘the role of autonomy in recovery,’ ‘impact of out-of-area placements,’ and ‘specialist training for staff.’ The findings demonstrated that the journey of serviceusers can be impacted by a wide range of factors, including relationships with staff, the nature of support offered, community response, financial constraints, and organisational goals around bed pressures.Conclusions: Recommendations include the need for staff to work in partnership with service users and carers, foster autonomy, access specialised suicide prevention training, and agree discharge and contingency plans with service users. Further work is needed to deliver the best possible experience for individuals with complex mental health needs and those who care for them.

Background Anxiety has been reported to be one of the most common epidemics in recent years. The present study focused on understanding the association between early menarche and the prevalence of anxiety and anxiety symptoms among adult undergraduate students. Methods This was an observational, case-control study. The sample included 146 young female adults aged more than or equal to 18 years pursuing the Bachelor of Medicine and Bachelor of Surgery (MBBS) and Bachelor of Dental Sciences (BDS). Using an online questionnaire, participants were asked to recall and enter the age at which they attained menarche. We used the Generalized Anxiety Disorder 7- Item Questionnaire (GAD-7) to measure the severity of their present anxiety symptoms. Results The results showed a significant increase in anxiety symptoms in participants who had early menarche compared to those who did not have early menarche. The mean score on the GAD-7 Questionnaire for the cases was 9.93 and the control group was 6.89. The GAD-7 scores among the cases group were significantly higher in the GAD-7 scores than in the control group. Conclusions This study concluded that early menarche is associated with higher anxiety levels in young adults.

Background Globally, the number of older adults is increasing rapidly; simultaneously, there is an epidemiological shift toward chronic diseases. One such chronic disease is type 2 diabetes mellitus (DM) which is caused either by the inability to produce insulin or due to the ineffective use of insulin. In recent years, self-management programmes for chronic conditions have gained importance, especially among occupational therapists. Though there is an increasing focus on ‘self-management interventions’ among older adults, there is still a lack of such interventions for older adults with type 2 DM in low- or middle-income countries (LMICs).Objectives Summarise the existing literature on self-management intervention programmes for community-dwelling older adults with type 2 DM; identify the principles, practices and criteria that define a self-management intervention programme for community-dwelling older adults with type 2 DM in LMICs.Methods This present study will be a scoping review, combining quantitative and qualitative literature with a parallel results convergent synthesis design. The synthesis applies to analysing existing principles and practices that influence the selection and application of ‘diabetes self-management intervention’ among older adults in community settings with type 2 DM in LMICs.Ethics and dissemination As a secondary analysis, this scoping review does not require ethics approval. The final review results will be submitted for publication in a peer-reviewed journal in the rehabilitation, diabetes, occupational therapy or health promotion-related fields. Other dissemination strategies may be an oral presentation at international conferences or through various social media networks.